Highlights
- •Diabetes is a risk factor for kidney cancer among non-obese post-menopausal women.
- •Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a BMI < 30 kg/m2.
- •Time-dependent diabetes is associated with kidney cancer risk among post-menopausal women with a waist circumference <34.6 in..
Abstract
Background
Many studies have reported a positive association between diabetes and kidney cancer.
However, it is unclear whether diabetes is a risk factor for kidney cancer independent
of other risk factors, such as obesity and hypertension. We comprehensively examined
the association of diabetes and its duration with incident kidney cancer in the prospective
cohort Iowa Women’s Health Study (1986–2011).
Methods
Diabetes status was self-reported at baseline (1986) and on five follow-up questionnaires.
Cox proportional hazards regression was used to calculate hazard ratios (HRs) and
95% confidence intervals (CIs) for the associations of baseline and time-dependent
diabetes with the risk of incident kidney cancer.
Results
During the 25 years of follow-up, 245 cases of kidney cancer occurred among 36,975
post-menopausal women. In an age-adjusted model, there was a significant association
between time-dependent diabetes and the risk of kidney cancer [HR (95% CI) = 1.76
(1.26, 1.45)]; the association was attenuated after multivariable adjustment for age,
body mass index (BMI), waist-to-hip ratio (WHR), hypertension, physical activity,
diuretic use, pack-years of smoking, alcohol intake, and total caloric intake [HR = 1.35
(0.94, 1.94)]. However, among non-obese women or women with a waist circumference
less than 34.6 in., diabetes was significantly associated with kidney cancer risk:
for time-dependent diabetes, HRs (95% CIs) were 1.82 (1.10, 3.00) among those with
BMI < 30 kg/m2 and 2.18 (1.08, 4.38) among those with a waist circumference <34.6 in..
Conclusions
Our results suggest that diabetes is associated with kidney cancer risk among non-obese
post-menopausal women.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to MaturitasAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Renal cell carcinoma: diagnosis, staging, and surveillance.AJR Am. J. Roentgenol. 2008; 191: 1220-1232
- Cancer statistics, 2020.CA Cancer J. Clin. 2020; 70: 7-30
- Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies.Lancet. 2008; 371: 569-578
- Body size and renal cell cancer incidence in a large US cohort study.Am. J. Epidemiol. 2008; 168: 268-277
- Body size and risk of renal cell carcinoma in the European Prospective Investigation into Cancer and Nutrition (EPIC).Int. J. Cancer. 2006; 118: 728-738
- Evaluation of dietary, medical and lifestyle risk factors for incident kidney cancer in postmenopausal women.Int. J. Cancer. 2004; 108: 115-121
- Nutrient and fiber intake and risk of renal cell carcinoma.Nutr. Cancer. 2008; 60: 720-728
- Carotenoid and vitamin intake, von Hippel-Lindau gene mutations and sporadic renal cell carcinoma.Cancer Causes Control. 2008; 19: 125-134
- Intakes of fruits, vegetables, vitamins A, C, and E, and carotenoids and risk of renal cell cancer.Cancer Epidemiol. Biomarkers Prev. 2006; 15: 2445-2452
- No association between fruit, vegetables, antioxidant nutrients and risk of renal cell carcinoma.Int. J. Cancer. 2010; 126: 1504-1512
- Dietary fiber intake and risk of renal cell carcinoma: evidence from a meta-analysis.Med. Oncol. 2014; 31: 125
- Diet and vitamin or mineral supplements and risk of renal cell carcinoma in Canada.Cancer Causes Control. 2003; 14: 705-714
- Calcium, vitamin D and cancer.Anticancer Res. 2009; 29: 3687-3698
- Diabetes mellitus and incidence and mortality of kidney cancer: a meta-analysis.J. Diabetes Complic. 2013; 27: 357-364
- Diabetes mellitus and the risk of cancer: results from a large-scale population-based cohort study in Japan.Arch. Intern. Med. 2006; 166: 1871-1877
- Risk factors for renal cell cancer: the multiethnic cohort.Am. J. Epidemiol. 2007; 166: 932-940
- Risk of cancer in a large cohort of U.S. Veterans with diabetes.Int. J. Cancer. 2011; 128: 635-643
- Type 2 diabetes and the risk of renal cell cancer in women.Diabetes Care. 2011; 34: 1552-1556
- Type 2 diabetes in relation to the risk of renal cell carcinoma among men and women in two large prospective cohort studies.Diabetes Care. 2018; 41: 1432-1437
- Accuracy and reliability of self-measurement of body girths.Am. J. Epidemiol. 1988; 128: 740-748
- Incidence of colorectal cancer in relation to glycemic index and load in a cohort of women.Cancer Epidemiol. Biomarkers Prev. 2006; 15: 892-896
- Survival Analysis: A Self-learning Text.2 ed. Springer-Verlag, New York2005
- Obesity and risk of type 2 diabetes and cardiovascular disease in children and adolescents.J. Clin. Endocrinol. Metab. 2003; 88: 1417-1427
- Increased incidence of diabetes mellitus in relation to abdominal adiposity in older women.J. Clin. Epidemiol. 1991; 44: 329-334
- Diabetes mellitus and hypertension.Hypertension. 1992; 19: 403-418
- Waist Circumference and Waist-Hip Ratio : Report of a WHO Expert Consultation.World Health Organization, Geneva2008: 8-11 (December 2008)
- Diabetes mellitus and incidence of kidney cancer: a meta-analysis of cohort studies.Diabetologia. 2011; 54: 1013-1018
- Risk factors for renal cell carcinoma in the VITAL study.J. Urol. 2013; 190: 1657-1661
- Kidney cancer and diabetes mellitus: a population-based case-control study in Taiwan.Ann. Acad. Med. Singap. 2013; 42: 120-124
- Diabetes and cancer.Endocrinol. Metab. Clin. North Am. 2014; 43: 167-185
- Diabetes mellitus as a risk factor for high grade renal cell carcinoma.Asian Pac. J. Cancer Prev. 2014; 15: 3993-3996
- Prognostic implications for insulin-sensitive and insulin-resistant normal-weight and obese individuals from a population-based cohort.Am. J. Clin. Nutr. 2012; 96: 962-969
- Metabolically healthy obesity (MHO) in the Malmö diet cancer study - Epidemiology and prospective risks.Obes. Res. Clin. Pract. 2019; 13: 548-554
- A Nested Case-Control Study of Metabolically Defined Body Size Phenotypes and Risk of Colorectal Cancer in the European Prospective Investigation into Cancer and Nutrition (EPIC).PLoS Med. 2016; 13: e1001988
- Metabolic obesity phenotypes and risk of colorectal cancer in postmenopausal women.Int J Cancer. 2018; 143: 543-551
- The association between metabolic health, obesity phenotype and the risk of breast cancer.Int J Cancer. 2017; 140: 2657-2666
- Alcohol intake and risk of renal cell carcinoma: a meta-analysis of published case-control studies.Arch Med Sci. 2011; 7: 648-657
- Effects of moderate alcohol intake on fasting insulin and glucose concentrations and insulin sensitivity in postmenopausal women: a randomized controlled trial.Jama. 2002; 287: 2559-2562
- Diabetes mellitus with obesity is a predictor of recurrence in patients with non-metastatic renal cell carcinoma.Jpn. J. Clin. Oncol. 2013; 43: 740-746
- The role of diabetes mellitus in the aetiology of renal cell cancer.Diabetologia. 1999; 42: 107-112
- The von Hippel-Lindau gene, kidney cancer, and oxygen sensing.J. Am. Soc. Nephrol. 2003; 14: 2703-2711
- Von Hippel-Lindau syndrome.Front. Horm. Res. 2013; 41: 30-49
Article info
Publication history
Published online: August 11, 2020
Accepted:
July 28,
2020
Received in revised form:
June 22,
2020
Received:
December 9,
2019
Identification
Copyright
© 2020 Elsevier B.V. All rights reserved.